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The Committee for a Responsible Federal Budget (CRFB) on Monday released a paper providing its preliminary estimates for various ways to finance "Medicare for All," as the issue of how to pay for such a health plan has taken center stage in the Democratic presidential primary. "Policymakers have a number of options available to finance the $30 trillion cost of Medicare for All, but each option would come with its own set of trade-offs," the budget watchdog group wrote. (Jagoda, 10/28)

As Sen. Elizabeth Warren develops her proposal for financing Medicare for All and reshaping how Americans pay for health care, she faces a complex set of challenges. The Democratic presidential hopeful from Massachusetts could propose a plan to partly pay for a single-payer system by finding ways to reduce health-care costs, expanding budget deficits or adding new levies on the richest Americans. But replacing insurance premiums would likely require taxes on individuals and businesses. (Rubin, 10/28)

Sen. Kamala Harris (D-Calif.) says she knew she would be “called a flip-flopper” when she backed away from her initial support for "Medicare for All" in favor of developing her own health care plan. Harris has come under criticism in the Democratic presidential race for shifting her position on Medicare for All, originally saying in January, “Let’s eliminate all that,” in reference to private insurance. (Sullivan, 10/28)

New Yorkers are waiting hours and lining up down the street to tell state legislators the same refrain: fix health care. Workers, physicians, nurses, parents, business owners, the elderly and the infirm have been testifying at hearings around the state about the New York Health Act, which would establish universal, guaranteed health care across the state with a single-payer plan. During the most recent forum, at a public library in the Bronx last week, people filled a 150-seat auditorium to hear testimony that ultimately ended when the library closed for the day. (West and Vielkind, 10/28)

The Trump administration announced Monday that it is shutting down one of the largest U.S. facilities for child migrants, which had come under intense criticism because of its regimented conditions and the contractor's ties to a freshly departed White House official. The U.S. Department of Health and Human Services said in a statement that it has reduced bed capacity from 1,200 to zero and the contract with Comprehensive Health Services Inc. is set to end on Nov. 30. About 2,000 workers will be let go in the coming days. (Gomez Licon, 10/28)

Caliburn, the contractor that operates the facility on land owned by the Department of Labor, will not have its federal contract renewed when it expires on Nov. 30 — though the facility will be placed into “warm status,” which means HHS will retain access to Homestead and can reopen it. The remaining staff members at Homestead will be released in the next five to seven days, and the facility’s bed capacity will be reduced to zero, according to the email. (Daugherty and Madan, 10/28)

Unlike most other shelters for migrant children, which are run by nonprofit organizations, Homestead is owned and operated by the for-profit Caliburn. The temporary "influx shelter" cost roughly $750 per night per child to run, three times the cost of permanent, licensed shelters. The closing process actually started some months ago. Homestead stopped taking in new children in July and stopped holding unaccompanied minors altogether in August. (Del Valle, 10/28)

Homestead is the country's largest “influx” shelter, which houses children who cross the border without parents or family until they can be placed with a sponsor in the U.S. It was meant to only house children for a few days, but many ended up staying for weeks or longer. It has drawn the ire of congressional Democrats and Democratic presidential candidates. Former Rep. Beto O’Rourke (D-Texas), Sen. Amy Klobuchar (D-Minn.), Sen. Elizabeth Warren (D-Mass.) and Sen. Bernie Sanders (I-Vt.), all 2020 contenders, each visited the facility while in Miami for the first round of Democratic primary debates. Sanders and Warren notably climbed ladders to try to look over the fence. (Weixel, 10/28)

Google executives misled their own employees last week when they said a former top Department of Homeland Security official who had recently joined the company was “not involved in the family separation policy,” government emails obtained under the Freedom of Information Act reveal. In fact, Miles Taylor, who served as deputy chief of staff and then chief of staff to former Homeland Security secretary Kirstjen Nielsen, was involved in high-level discussions about immigration enforcement, helping to shape the department’s narratives and talking points as one of Nielsen’s trusted lieutenants. (Mac and Leopold, 10/28)

The Migrant Protection Protocols is now in effect in the Maverick County town of Eagle Pass, which borders the Mexican state of Coahuila. The policy requires most asylum seekers to wait for their court hearings in Mexico after being processed by U.S. immigration officials. (Aguilar, 10/28)

Senate Democratic leaders said they will force a floor vote as early as Wednesday in an attempt to overturn a Trump administration rule that allows states to ignore parts of ObamaCare. The resolution from Senate Minority Leader Charles Schumer (D-N.Y.) needs a simple majority to pass, meaning Democrats would need four GOP senators to vote against the Trump policy.  (Weixel, 10/28)

With open enrollment for 2020 health plans set to begin Friday, employees at Access Health CT, the state’s insurance exchange, are exploring new ways to reach people like Artes who don’t have coverage. Connecticut’s uninsured population dipped last year – to 5.3 percent, down from 5.5 percent – bucking a national trend, according to Census figures. (Carlesso, 10/29)

If a competitive health insurance market and stable premiums were all that mattered, local health care advocates say, then open enrollment that begins Friday for 2020 coverage under the Affordable Care Act would be smooth sailing. But scant federal promotion of the six-week sign-up period is once again fueling concerns that some people will miss a chance to obtain health insurance simply because they’re unaware of it. (Sechler, 10/28)

Kaiser Health News: Employers Are Scaling Back Their Dependence On High-Deductible Health Plans

Everything old is new again. As open enrollment gets underway for next year’s job-based health insurance coverage, some employees are seeing traditional plans offered alongside or instead of the plans with sky-high deductibles that may have been their only choice in the past. Some employers say that, in a tight labor market, offering a more generous plan with a deductible that’s less than four figures can be an attractive recruitment tool. (Andrews, 10/29)

U.S. Representative Greg Walden, the top Republican on the House Energy and Commerce Committee, said on Monday he will not seek re-election in November 2020, the latest Republican to announce his retirement. Walden, 62, who previously chaired the committee and oversaw many legislative efforts, said in a statement released by his office that he believes he would have been re-elected if he had run. Walden, who is from Oregon, has been in Congress since 1999 and is deputy chairman of the National Republican Congressional Committee. (10/28)

The Energy and Commerce Committee oversees health care, telecommunications, energy and environmental policymaking. Among his achievements, he cited passage of legislation to deal with the opioid crisis, expand broadband service and improve the health of forests. (Wasson, 10/28)

As chairman of the Energy and Commerce Committee, which has primary jurisdiction over health care issues in the House, Walden played a key role in the GOP's efforts to repeal and replace ObamaCare in 2017. (Brufke, 10/28)

Google owner Alphabet Inc has made an offer to acquire U.S. wearable device maker Fitbit Inc, as it eyes a slice of the crowded market for fitness trackers and smartwatches, people familiar with the matter said on Monday. While Google has joined other major technology companies such as Apple Inc and Samsung Electronics Co Ltd in developing smart phones, it has yet to develop any wearable offerings. (Roumeliotis and Dave, 10/28)

The deal would make Alphabet a player in the wearable fitness tracking space, competing against the likes of Apple, which recently released a new version of its popular smartwatch. Google licenses its Wear operating system to companies such as Fossil but does not currently make its own smartwatch. (Feiner and Sherman, 10/28)

Fitbit, which in its latest quarterly earnings posted a loss of $68.5m, is looking precarious as a standalone entity since bigger firms have gained a strong footing in wearable technology. "A key tipping point is likely to have been Apple's decision to price its Series 3 Apple Watch at $199/£199," said Leo Gebbie, from the consultancy CCS Insight. (Lee, 10/28)

The nation's two ride-sharing giants are continuing their push into healthcare, announcing major expansions of their work within days of one another. Uber on Monday announced its healthcare arm plans to integrate an app into Cerner Corp.'s electronic health record system, which would allow caregivers to schedule rides for patients. Lyft last week said it is now providing covered rides for eligible Medicaid beneficiaries in Georgia, Michigan, Missouri, Tennessee and Virginia. (Cohen, 10/28)

Healthcare fraudsters deliver measurably worse care that can harm patients, according to a new study. Patients treated by organizations later excluded from the Medicare program for fraud and abuse were between 14% to 17% more likely to die than those who were treated by their law-abiding counterparts, according to a new study from researchers at Johns Hopkins Bloomberg School of Public Health. Fraud and abuse contributed to 6,700 premature deaths in 2013 alone, their analysis shows. (Kacik, 10/28)

Facebook has launched a new feature to help track what preventive health screenings might be recommended for you based on your age and sex. The tool, called Preventive Health, rolled out in the United States on Monday and focuses specifically on cardiovascular health, cancer screening and seasonal flu -- making recommendations such as when to get a cholesterol test or where to get a flu shot. (Howard, 10/28)

The company says the feature is intended to encourage more people to take steps to prevent health issues. “I take care of patients every day who come in with acute heart attacks,” said Freddy Abnousi, a practicing doctor who is head of health-care research at Facebook. “Every time we bring someone back from the abyss, because that’s basically how they show up, we always wonder how we could have prevented some of this.” This new feature, Abnousi hopes, will get people to see their doctor with more regularity. (Wagner, 10/28)

Facebook said it’s put up strict safeguards to protect the privacy of people who use the new tool. The company vowed not to share the data generated through the tool with third parties. It won’t let other users on Facebook see when people use the feature. Nor will it allow advertisers to target ads to users based on the information they share using the tool — though they might see targeted ads if they click through to another website or navigate away to like the page of a health care organization. Within Facebook, the data from the tool will be accessible only to a subset of employees focused on keeping the feature functional. (Robbins, 10/28)

Juul Labs Inc. plans to cut roughly 500 jobs by the end of the year, according to people familiar with the matter, reversing the embattled e-cigarette maker’s rapid staff growth as the company braces for a proposed ban on flavors that make up more than 80% of its U.S. sales. The number of positions to be eliminated could range from 10% to 15% of the workforce but isn’t final, the people said. (Maloney, 10/28)

In a statement to CNBC, the company said the cuts were part of a broad review of the company’s practices and policies by its CEO K.C. Crosthwaite. The cuts will represent about 10 to 15% of Juul’s workforce. The San Francisco-based company currently employs about 4,100 people. Juul was hiring about 300 people a month as it grew from a small start-up in 2015 to a company valued at $38 billion late last year. (Setty, 10/28)

A Colorado teenager has filed a federal lawsuit against vaping giant Juul, claiming the company’s electronic cigarettes caused him permanent injuries that will require lifelong medical treatment. Mohammed Aldawoodi, 19, filed the lawsuit Friday in U.S. District Court in Denver, claiming Juul “intentionally targeted adolescents” in marketing campaigns while “negligently failing to adequately and correctly warn the Plaintiff and the public of the dangers of Juul.” (Nicholson, 10/28)

Sherry Musso doesn’t like swallowing pills. To take her vitamins, she inhales them from a penlike device that vaporizes them. “I puff on the B12 as soon as I get up. It gives me that little boost of energy and helps me wake up,” said the 31-year-old former smoker from an Atlanta suburb. Her vaporized vitamins are part of her wellness regimen. At night, she puffs melatonin. (Hernandez and Falk, 10/28)

Utah stores — not just tobacco specialty shops — will be allowed to sell flavored vape products for a while longer. A judge in Utah ruled Monday morning that a state cannot immediately enact an emergency ban on flavored e-cigarette products for general retailers, like grocery and convenience stores. (Alberty, 10/28)

Minnesota lawmakers in both parties announced plans Monday to offer a robust package of anti-nicotine legislation in the face of rapidly rising rates of teen vaping. Sen. Carla Nelson, R-Rochester, said she would renew a push to increase the legal age to buy nicotine products to 21 and ban flavored vape products. (Coolican and Adler, 10/28)

Gov. Kim Reynolds will not pursue an executive order to ban vaping in Iowa. Instead, state health and education officials will focus on educational programs and a social media campaign warning minors of the health risks associated with e-cigarettes. (Gerlock and Krebs, 10/28)

In the wake of two Tennesseans dying in recent weeks from vaping-related lung illnesses, Gov. Bill Lee said last week he wants to see a clearer picture of the problem before having the state take action. ...As of Thursday, there have been 57 cases of lung illness linked to vaping or e-cigarette use in Tennessee, including the two deaths. The current outbreak has resulted in more than 1,600 illnesses and 34 deaths around the nation, according to the Centers for Disease Control and Prevention. (Ebert, 10/28)

Walgreens will shutter nearly 40% of the clinics in its stores as the drugstore chain cuts costs and shifts to other businesses it believes will draw more people through its doors. The company said Monday that it will close 150 Walgreens-run clinics by the end of the year, but it will keep open more than 200 that are run in partnership with health care providers. (Murphy, 10/28)

Walgreens said it will offer Jenny Craig meal-planning and weight-loss consultations at 100 locations starting in January 2020. Under an existing deal with medical-testing company LabCorp, customers will be able to get blood and other lab tests in at least 600 Walgreens stores in the next few years. (Langreth, 10/28)

Walgreens and rival CVS Health Corp. both see establishing themselves as treatment centers for chronically ill patients as a way to offset slowing revenue from prescription drugs and competition from online retailers. The two chains are taking different approaches. Walgreens has increasingly sought partnerships with other companies and health systems, while CVS is executing its plan through acquisitions or by building its own new business. (Terlep, 10/28)

Walgreens shares have fallen nearly 19% this year as the drugstore chain struggles to convince investors it has a plan to compete with old rivals like CVS and new ones like Amazon. Walgreens recently announced a partnership with Alphabet’s Wing to test using drones to deliver nonprescription items like groceries and over-the-counter medicines. That’s in addition to the more than one dozen partnerships Walgreens has already made to bring new services to its drugstores, such as dental and doctors offices. (LaVito, 10/28)

Walgreens laid off employees at its Deerfield headquarters last week and won’t pay annual bonuses this year as it works to increase its cost-cutting goal to $1.8 billion annually. The actions come as Walgreens, which has 18,750 stores worldwide, grapples with changes including how consumers use pharmacies. (Schencker, 10/28)

At one smoldering end of California, Capt. Alex Arriola and hundreds of other firefighters charged up flaming hillsides in the middle of the night Monday to battle a brush fire that exploded on the tinder-dry edge of West Los Angeles. As helicopters doused the hills to protect the priceless artworks at the nearby Getty Center and homes went up in flames, the fire crews on the ground began attacking the blaze to keep it from leaping across the street and taking out other multimillion-dollar houses. (Arango, Fuller, Del Real, Healy, 10/28)

As fire blazed just eight miles away from Sutter Santa Rosa Regional Hospital, its chief executive Mike Purvis received a phone call from the Sonoma County Sheriff’s Office and Cal Fire, the state’s fire agency. The hospital was officially being ordered to evacuate. Within minutes of the Saturday evening call, his staff was in motion. They went into an incident command center in an empty conference room and started calling other hospitals to find a place for each patient. (Kelly, Wilson and Lanzendorfer, 10/28)

California’s recent power shut-offs, meant to reduce the risk of potentially catastrophic fires, have had an unwelcome side effect. The blackouts have also cut power to many cellphone towers, blocking the main communications source for many in harm’s way. “You don’t appreciate how essential cellphone service is until you lose it,” said Chris Ungson, deputy director for communications and water policy for the California Public Advocates Office, an independent agency within the state’s Public Utilities Commission. “It’s not just a matter of inconvenience; it’s a matter of public health and safety. It’s a lifeline to many, many people.” (Pogash and Chen, 10/28)

Collectively, the fires and blackouts contributed to a sense of a state under siege, with almost nowhere in California operating free from threat. The brush fire in Los Angeles began Monday before 2 a.m. and spread to 618 acres by noon, according to the Los Angeles Fire Department. More than 10,000 homes and businesses in West Los Angeles were under mandatory evacuation orders as more than 1,000 firefighters battled flames on the ground and in the air. (Lovett, Calfas and Carlton, 10/28)

Even for those miles away from the flames and power outages, smoke plumes from California’s wildfires are disrupting people’s lives, degrading air quality from the Bay Area to L.A.'s Westside and contributing to widespread school closures. More than 10,000 students across the Santa Monica and Malibu areas were forced to stay home Monday after being alerted about 6:30 a.m. that all schools in their district would be closed because of the Getty fire. (Barboza, 10/28)

With wildfires raging up and down the state of California on Monday, smoke filled the air in many places, ash fell from the sky, and residents were once again left to wonder whether the very air they were breathing was safe. The largest, the Kincade fire in Sonoma County north of San Francisco, nearly doubled in size in 24 hours and was just 5 percent contained on Monday, prompting volunteers downwind in the Bay Area to scramble to hand out masks and check on homeless residents. (Mervosh, 10/28)

Online or in hardware stores, look for masks marked as either N95 or P100. The designation indicates that the respirator blocks at least 95-99% of particulate matter floating in the air. Those microscopic specks can cause respiratory issues and trigger heart attacks. Do not use dust or surgical masks; they're not up to the job. (McClurg, 10/28)

Two major wildfires burned through hundreds of acres in Sonoma County and Los Angeles County on Monday, forcing evacuations and prolonging planned blackouts meant to deter future fires. (Bloch and Lai, 10/28)

Rhonda Taylor got back to her Palisades home around 1 a.m. Monday and was getting ready for bed when she saw images of a fire on the TV. Taylor assumed it was burning somewhere in the Valley, and even if it was closer, she reasoned, the blaze that broke out in the Palisades last week hadn’t prompted an evacuation of her neighborhood. She fell asleep. Taylor woke around 3 a.m. to her phone ringing and the smell of smoke. Her throat was parched and her head hurt. She answered to a Los Angeles County phone alert, telling her she needed to leave. (Ormseth and Sahagun, 10/28)

Wildfire season across the entire western part of the country is becoming more intense and more expensive every year. The federal government spent more than $2.4 billion on fire suppression in 2017. That’s the most expensive year on record, and costs are expected to rise further as climate change contributes to more frequent and severe wildfires. (Adams, 10/28)

In what may be a watershed moment in the fight against tuberculosis, the world’s most lethal infectious disease, an experimental new vaccine has protected about half the people who got it, scientists reported on Tuesday. While a 50 percent success rate is hardly ideal — the measles vaccine, by contrast, is about 98 percent protective — about 10 million people get tuberculosis each year, and 1.6 million die of it. Even a partly effective vaccine may save millions of lives. (McNeil, 10/29)

There is a TB vaccine now, but it's given only to very young children and partly prevents severe complications. Researchers have been seeking a vaccine that also works in adults, to curb spread of the disease. GlaxoSmithKline's experimental vaccine was tested in nearly 3,600 adults in Africa. Results were reported Tuesday at a conference in India and published by the New England Journal of Medicine. (10/29)

Dr Lewinsohn estimates that, if if all goes well, the vaccine should reach people who most need it by about 2028. Researchers say proving that the vaccine works often requires studies that are much larger than required for viral diseases such as measles. Drug firm GlaxoSmithKline (GSK) has been working on the TB vaccine for nearly 20 years. (Biswas, 10/29)

For decades, scientists and doctors have treated common bacterial and viral infections with fairly blunt therapies. If you developed a sinus infection or a stomach bug, you would likely be given a broad-spectrum antibiotic that would clear out many different types of bacteria. Antiviral drugs help treat viral illnesses in much the same way, by hindering the pathogen’s ability to reproduce and spread in the body. (Sheikh, 10/28)

GlaxoSmithKline Plc said on Monday it has begun a late-stage study testing its experimental antibiotic in patients with urinary tract infection and gonorrhoea, a type of sexually transmitted infection. The antibiotic, gepotidacin, is the first of a new class of drugs and is expected to treat the two common infections caused by bacteria - identified as antibiotic resistant threats by U.S. health regulators. (10/28)

Talking about guns can be difficult, even for physicians. That's according to a new study published Monday in JAMA Pediatrics. The study found that pediatricians and pediatric residents were less likely to ask their patients about gun storage safety than smoke alarm safety — indicating an overall hesitation in bringing up gun safety with their patients. (Asmelash, 10/28)

Leaders from three of the world's major religions have joined forces against assisted suicide and euthanasia, in a declaration issued at the Vatican. The declaration, backed by leaders of Christianity, Islam and Judaism, states that no health care provider should be "coerced or pressured" into providing assisted suicide or any form of euthanasia. (10/28)

In recent years, hospitals and medical centers across the country have stopped selling sugar-sweetened beverages in an effort to reduce obesity and diabetes. Now a new study carried out at the University of California, San Francisco, has documented the health impact of a soda sales ban on its employees. Ten months after a sales ban went into effect, U.C.S.F. workers who tended to drink a lot of sugary beverages had cut their daily intake by about half. (O'Connor, 10/28)

If you clicked on this story, you likely either have or are thinking about getting some ink. It might be your first embellishment (in tattoo-speak, you're a tenderfoot), or maybe it's your sixth (on your way to being a showcase). And you're part of a massive trend. Nearly four in 10 millennials ages 18 to 29 have a tattoo; half of those have two to five tats, the vast majority hidden under clothing, according to a 2010 Pew Research Center report. (LaMotte, 10/29)

When Nathaly Sweeney launched her career as a pediatric heart specialist a few years ago, she says, it was a struggle to anticipate which babies would need emergency surgery or when. "We just didn't know whose heart was going to fail first," she says. "There was no rhyme or reason who was coming to the intensive care unit over and over again, versus the ones that were doing well." (Harris, 10/28)

Psychologists have a new directive for anxious teens: Post selfies on Instagram and Snapchat. Most teens, it can seem to grown-ups, need to be pulled away from social media. Teens with anxiety disorders, however, may need to be pushed toward it. Social media and texting can be a minefield for any teen, but it is particularly daunting for those who struggle with anxiety: They might worry excessively about posting the “right” picture or comment, count the number of likes on their posts, or negatively compare their Saturday night at home with their peers’ festive party pictures. (Petersen, 10/28)

Could a simple eye exam detect signs of Alzheimer’s disease? Researchers at Massachusetts General Hospital and Brigham and Women’s Hospital have begun a study to find out. Dr. Gad Marshall, associate professor of neurology at Harvard Medical School, is testing a special retina camera and software developed by a Canadian startup to determine whether it can identify bits of amyloid plaques in the back of the eye that may indicate Alzheimer’s. (Saltzman, 10/28)

Childhood anxiety is one of the most important mental health challenges of our time. One in five children will experience some kind of clinical-level anxiety by the time they reach adolescence, according to Danny Pine, a child and adolescent psychiatrist at the National Institute of Mental Health and one of the world's top anxiety researchers. Pine says that for most kids, these feelings of worry won't last, but for some, they will — especially if those children don't get help. (Turner, 10/29)

A powerful flu shot that provides extra protection for older people with weaker immune systems is becoming a hot commodity for health-minded seniors. But as a new flu season gets underway, it’s not always easy to find. (Weisman, 10/28)

When people take their hypertension medications at bedtime, blood pressure is better controlled during the night and the risk of death or illness due to cardiovascular disease is significantly lowered, a new study suggests. Researchers who followed nearly 20,000 patients for a median of six years found that patients who took their medications at bedtime cut their overall risk of dying from cardiovascular causes during the study nearly in half compared with those taking the drugs in the morning, the study found. (10/29)

[Alex] Boniello’s experience reflects a tricky problem for shows and plays that portray suicide. Even if producers have tried to handle the issue with sensitivity — by hiring mental health consultants for the script, adding the suicide prevention hotline to their program, or partnering with nonprofits to provide mental health resources — they are still left to grapple with the deeply personal fan mail that pours in after it premieres. (Thielking, 10/29)

The closer a child in New York City lives to a fast-food restaurant, the more likely the child is to be overweight or obese, according to a new analysis by researchers at New York University School of Medicine. It is the small distances—a half block or a block from a fast-food outlet—that matter the most, said Brian Elbel, of the Department of Population Health, NYU School of Medicine and Wagner Graduate School of Public Service. (West, 10/29)

When her husband, Bill, died six years ago this month, Michele Zawadzki squared her shoulders to the grief. They had been together for 47 years — since high school, when they were prom dates — so she knew that life without him would be trying. Not just holidays, but even mundane matters like taking care of the car. When a pipe broke in her toilet, spraying water all over, Ms. Zawadzki, 68, didn’t know what valve to turn off or whom to call. Mail for him kept coming. (Nierenberg, 10/28)

Seeking to reduce a rising tide of shortages, the Food and Drug Administration is considering the idea of creating a system to rate manufacturing facilities run by drug makers. The hope is that customers — notably, group purchasing organizations for hospitals, but also consumers — would reward drug companies that consistently make medicines that conform to quality standards. In doing so, this could yield steady sales that would, in turn, provide incentives for further investment in facilities and, hopefully, lessen the likelihood of the sorts of quality issues that lead to shortages. (Silverman, 10/28)

The House on Monday is poised to pass a handful of modest bipartisan bills related to drug prices and e-cigarettes, as Democrats negotiate among themselves on more ambitious actions to address the high-profile issues. The chamber will take up two drug pricing bills, another bill (HR 3942) that will require age verification for online e-cigarette sales, and three other bills that would extend health workforce and education programs. (Siddons, 10/28)

The House today unanimously passed a bill that would require more public disclosure of the discounts drug companies give to pharmacy benefit managers. Rep. Abigail Spanberger's bill, H.R. 2115 (116), approved 403-0, would require PBMs to report to HHS their aggregate rebates, discounts and other price concessions received on drugs from manufacturers. (Karlin-Smith, 10/28)

A controversial treatment for preventing premature births will be reviewed by a Food and Drug Administration advisory panel on Tuesday amid intensifying debate over whether the medication, called Makena, should remain on the market. The panel is set to review a required followup study that found the medicine was not effective, a troublesome development given that Makena has become the standard of care since winning FDA approval nine years ago. (Silverman, 10/28)

AstraZeneca said Monday that its two immunotherapy cancer drugs, when combined with chemotherapy, slowed the progression of late-stage non-small cell lung cancer compared to chemotherapy alone. The result comes just six days after Bristol-Myers Squibb reported similar findings with its own immunotherapy drugs and will likely lead to speculation as to whether Merck can hold onto its dominance in lung cancer with its treatment, Keytruda. Both data releases included only preliminary and incomplete data for investors, with full scientific results to follow in the future. (Herper, 10/28)

AstraZeneca Plc’s novel combination of cancer treatments succeeded in a final-stage study, showing utility against lung tumors after a string of failures. Results from the trial of tremelimumab in combination with Imfinzi, an approved cancer drug, and standard chemotherapy showed a statistically significant and meaningful improvement in a measure of cancer progression, AstraZeneca said in a statement. (Lauerman, 10/28)

Kaiser Health News: Moved Overseas For School, Stayed For Insulin

Every now and then, Katie West considers returning to the United States. She moved to Germany for graduate school three years ago and now works as a health systems researcher in Hamburg. Her family is an ocean away. Then she remembers why she stays. West, 30, has had Type 1 diabetes since she was 3. Back in Seattle, where she used to live, she typically paid $70 per month for insulin and another $130 for pump supplies. That was a relative steal in the U.S., made possible by her excellent health insurance, which she got through her employer. But still, it was a financial strain. (Luthra, 10/29)

State officials will make some revisions to a plan to overhaul TennCare after sharp criticism at public hearings this month, but the public won't find out what those changes are until after the plan is in the hands of the federal government. TennCare spokeswoman Sarah Tanksley said Monday the agency will not release its revised plan for a Medicaid block grant until the day the proposal is submitted to the Centers of Medicare and Medicaid Services, or CMS. (Kelman, 10/28)

An algorithm that dictates assignment of many Medicaid patients to health plans could cause another high-stakes tussle among plans that have received an estimated $90 billion worth of contracts to manage care in Florida’s Medicaid program. The state Agency for Health Care Administration submitted a report this month outlining options the Legislature could consider to make the process more “equitable” for health plans. (Sexton, 10/28)

A group of community health centers is suing the state for failing to pay them for the cost of providing certain services to low-income individuals who are uninsured. The lawsuit filed Monday in federal court says the Arizona Health Care Cost Containment System, the state’s Medicaid program, is required to reimburse “federally qualified health centers” for the costs of all services provided. That, the lawsuit says, includes not just care provided by doctors but also services furnished by dentists, podiatrists, optometrists and chiropractors. (Fischer, 10/28)

The fate of Missouri's only abortion clinic was at stake on Monday, as a state arbiter heard arguments from Planned Parenthood and state officials who have threatened to close it and make Missouri the sole U.S. state without legal abortion services. Planned Parenthood, the women's healthcare and abortion provider that operates the facility, sued the state health department in June for its refusal to renew the St. Louis clinic's license. The state court judge presiding over the case referred the matter to the Administrative Hearing Commission, an independent arbiter. (Langellier, 10/28)

On the first day of an administrative hearing that could determine the fate of Missouri’s sole abortion clinic, attorneys for the state questioned the safety of Planned Parenthood’s clinic and said state regulators acted with patients in mind when they did not renew its license. Lawyers spent hours attempting to prove through witness testimony the state’s Department of Health and Human Services acted legally when it did not issue a renewed license to Planned Parenthood Reproductive Health Services in St. Louis last June. (Fentem, 10/28)

“Grave concerns” about patient care at Planned Parenthood’s St. Louis clinic prompted state regulators to deny renewal of a license to perform abortions at the facility, the Missouri solicitor general said Monday at the opening of a closely-watched hearing. The case before the state’s administrative hearing commission could decide whether Missouri becomes the sole state without an abortion clinic. (Thomas, 10/28)

Ohio’s attorney general has asked a full federal appeals court to review a decision that prevented the state from enforcing a law that bans an abortion after a test shows a fetus has Down syndrome. Attorney General Dave Yost’s office wants the full court to overturn a 2-1 ruling by a three-judge panel from the 6th U.S. Circuit Court of Appeals from earlier this month that blocked the law from going into effect. (Heisig, 10/28)

A bitter custody battle in Dallas that centers on the gender identity of a 7-year-old child provoked an outcry among conservatives this month. The child’s mother, Anne Georgulas, had honored what she said was the child’s preference to live as a girl and sought to compel the father, Jeffrey Younger, to do the same, according to court documents. But Mr. Younger insisted that the child is a boy and said that Ms. Georgulas was manipulating the child’s identity. (Zraick, 10/28)

A Twin Cities nonprofit is hoping that financial management can address one of the sad realities of modern cancer care — that the latest treatments are savings lives, but leaving survivors without money to live. Eligible cancer patients will be paired with certified financial planners and navigators as part of a two-year test project by Angel Foundation, a Mendota Heights-based charity that already supports cancer patients with costs of food and other basic needs, and with counseling and resources to continue to be effective parents amid treatment. (Olson, 10/28)

A patient who sued the University of Kansas Hospital for fraud and negligence, alleging she was misdiagnosed with pancreatic cancer and the hospital covered it up, quietly settled her case last year on confidential terms. Although the settlement was sealed, KCUR has learned that the Kansas agency that provides excess insurance coverage for medical providers –insurance over and above the providers’ primary coverage – agreed to pay out $1.8 million on behalf of the hospital and the doctor who made the misdiagnosis. (Margolies, 10/28)

A national shift in how the federal Housing Opportunities for Persons with AIDS program funds local rental assistance and other programs will slash Atlanta’s budget from $23 million to as low as $9 million in about two years, according to estimates. This 60% drop will be the second steepest in the nation and comes as the metro experiences one of the nation’s highest rates of new AIDS/HIV diagnoses, according to public health experts. (Mariano, 10/28)

Leading Health Care of Louisiana, a home health care company that employs more than 2,000 people statewide, is building a 20,000-square-foot office at 206 La Rue France, officials announced. The $4.5 million project is projected to be complete by summer 2020. Ken Smalling, the company's chief strategy officer, said in the announcement that the move was due to the growth from taking on new Medicaid Waiver Services clients and clients with long-term care insurance or with the VA's Homemaker and Home Health Aide programs. (Boudreux, 10/28)

A Cincinnati City council member is calling for a boycott of a local hospital network after a nurse posted disparaging remarks about transgender and gay people on her personal Facebook page. Councilman Chris Seelbach is calling for a boycott of TriHealth in the wake of the two graphic, expletive-laden social media posts from a Bethesda Butler Hospital nurse in which she denies transgender identity exists and uses a gay slur. (Coolidge and Saker, 10/28)

Across the country, a growing consensus of medical and mental health professionals have equated placing prisoners in solitary confinement to torture. In Florida, a group of civil rights groups suing to end the practice have measured rates of confinement in state prisons at twice the national average, including hundreds of people who have been in isolation for six to 20 years. (Conarck, 10/28)

Authorities are urgently searching for a 4-year-old Nebraska boy and his mother, who has been charged with child abuse for allegedly ending her son's treatment for cancer and fleeing the state. A social worker reported that Prince Rehan missed several appointments at an Omaha hospital for treatment of Rhabdomyosarcoma, a rare but treatable form of cancer that forms in the soft tissue, according to Lincoln police investigator Luis Herrera. (10/28)

If you’ve watched the Democratic debates so far, you may have noticed a theme. The discussion, especially during the first hour, has focused on one issue: Medicare. That discussion has often felt repetitive, with Bernie Sanders and Elizabeth Warren arguing for one approach to expanding Medicare while the other candidates argue for a different approach. Enough already. (Leonhardt, 10/28)

Democratic presidential candidates Elizabeth Warren and Bernie Sanders have struggled to explain how they would pay for “Medicare for all.” This is puzzling. A single-payer approach like Medicare for all can reduce overall health spending. Other wealthy countries that have universal coverage spend far less on healthcare than the United States as a share of their gross domestic product.A lack of money is not the problem. That’s why it should not be difficult to devise a way to pay for Medicare for all to benefit the vast majority of us, particularly low- and middle-income earners. (Stephen Marks, 10/28)

Nearly a decade after its controversial implementation, it’s clear the Affordable Care Act, or Obamacare, is saving lives. Yet the Republican Party continues its relentless campaign to kill it. Defeating that campaign could be a matter of life or death for people like Bonnie Sparks, a heart patient profiled in a recent Washington Post deep dive on the real-world effects of Obamacare. Without it, “I would be dead or I would be financially ruined,” said Sparks, relating how she risked — and then suffered — a heart attack because she couldn’t afford her prescribed blood thinner. She now has coverage through Obamacare. (10/27)

When I learned last week that Biogen had completed a retrospective analysis of the aducanumab data — the same data that seven months earlier the company had said justified stopping work on the drug — I thought of my father, my friend, George Scangos, and people around the globe with Alzheimer’s, ALS, and other diseases for which there are no cures. I hope that Biogen made a mistake in its futility analysis back in March. But if it didn’t, and this is another example of the American public watching big pharma trying to spin bad data, then I can’t help but wonder if Biogen, and perhaps the industry, has lost its way. (Ted Whitford, 10/28)

When I ran the VA’s Center for Women Veterans, one of my highest priorities was changing the culture throughout the organization to be more welcoming of women veterans, who make up a small but rapidly growing percentage of our nation’s veterans. That work is deeply necessary: Alarming research by the department found that one in four women veterans using VA health care “reported inappropriate and/or unwanted comments or behavior by male veterans on VA grounds.” Unsurprisingly, women who experienced that harassment were less likely to feel welcome, which could lead to them delaying or missing needed care. Just like in the military, younger women are at higher risk of experiencing that harassment. (Kayla Williams, 10/28)

Rarely would the head of the largest pro-life grassroots student organization, the former head of Planned Parenthood and an abortion supporting political candidate agree on commonsense limits on abortion. But in a political season in which Democratic candidates for president have more to say on saving the planet for future generations than on the practice of ending those generations in the womb, Rep. Tulsi Gabbard (D-Hawaii) has some advice for my family's former party that Democrats really should consider if they want to win. At last week’s Democratic debate, Gabbard has had the nerve to state the obvious; that abortions in the third trimesters when preborn babies can feel pain, when the risks to women dramatically rises, and as babies can live outside the womb should be curtailed. (Kristan Hawkins, 10/28)

On Monday, Port KC’s board — virtually without discussion or debate — gave initial approval to what could be millions in public subsidies to benefit the federal government, which is relocating more than 500 jobs here from Washington, D.C. The nation’s taxpayers will get a break because the incentives are designed in part to lower the government’s expenses for local office space. But Missouri taxpayers will pay the price in reduced funding for schools, health care and other state services. (10/29)

Several states have already placed a temporary ban on the sale of electronic smoking devices (ESDs). The Iowa Statehouse needs to take action and recognize youth vaping as a growing public health emergency. Legislators must recognize the nicotine in ESDs comes from the tobacco plant; therefore, vaping products like e-cigarettes should be considered tobacco products and receive the same regulation. (George Belitsos, 10/28)

Surprise billing is one of several issues in our health care system that must be addressed. However, the benchmarking approach in Senator Alexander’s bill would make things considerably worse for rural health care access. That’s because this approach would end up hitting rural hospitals and emergency rooms with substantial financial losses as it would set artificially low rates for physicians. (David May, 10/28)

Back in April, Ohio legislators passed and Gov. Mike DeWine signed one of the most extreme abortion bans in the country. This so-called Human Rights Protection Act outlaws abortions as early as five or six weeks into a pregnancy, before many women even know they’re pregnant. The law, which is not in effect and currently blocked by the courts, doesn’t allow for exceptions in cases of rape or incest. As a sexual-assault survivor, I know that carrying your rapist’s baby is the worst scenario imaginable for survivors. As extreme as Ohio’s new law is, I also know that barriers to abortion access have existed for decades, impacting the most vulnerable people. (Siqi Cheng, 10/28)